Objective In shared medical appointments (SMAs), multiple patients with a similar clinical diagnosis are seen by a multidisciplinary team for interactive group sessions. Very few studies have specifically studied SMAs and weight loss in patients with obesity. This study compared weight loss outcomes and anti-obesity medication (AOM) access between patients with obesity managed through (SMAs) versus individual appointments. Methods Retrospective study of adults seen for obesity between September 2014 and February 2017 at Cleveland Clinic Institute of Endocrinology and Metabolism. Percent weight loss from baseline was compared between two propensity score-matched populations patients who attended ?1 SMA and patients managed with individual medical appointments. Results From all eligible patients identified (n=310 SMA, n=1,993 non-SMA), 301 matched pairs were evaluated for weight loss. The SMA group (n=301) lost a mean of 4.2%, 5.2% and 3.8% of baseline weight over 6, 12 and 24 months; the non-SMA group (n=301) lost significantly less weight (1.5%, 1.8% and 1.6%, respectively) (paired t-test, P less then .05). All patients were eligible for US Food and Drug Administration-approved AOMs based on obesity diagnosis; however, 49.8% (150/301) of matched SMA patients were prescribed an AOM versus 12.3% (37/301) of matched non-SMA patients. Conclusion This study suggests that SMAs may offer a promising alterative for obesity management and one that may facilitate greater utilization of AOMs. In propensity score-matched cohorts, SMAs were associated with greater weight loss outcomes when compared to usual care facilitated through individual medical appointments alone.Objective To examine whether the promotion of water intake could reduce sugar-sweetened beverage (SSB) consumption or purchases independent of interventions that target SSBs. Methods Seven databases were systematically searched. Included studies used water promotion as the primary intervention; used a controlled trial, single group pre-post, or prospective cohort study design; included a measure of SSB consumption or purchase; enrolled human participants of any age who lived in high-income or middle-income countries; contained original data; and appeared in a peer-reviewed English-language article published from 1 January 2000 to January 4, 2019. The search yielded 7068 publications, from which 108 were chosen for full-text review. Seventeen were included in this review. Results Nine of the 17 studies were randomized controlled trials, six were nonrandomized controlled trials, and 2 were single-group pre-post studies. Participants were primarily children and adolescents. Interventions included water provision, education or promotion activities. Ten of 17 studies were at low or some/moderate risk of bias. Seven studies showed a statistically significant decrease in SSB consumption of which only 2 were at low or some/moderate risk of bias. Conclusions This review found limited evidence that interventions aimed solely at increasing water consumption reduce SSB intake. Further research is needed to investigate whether interventions that combine water promotion and SSB reduction strategies could be synergistic for reducing SSB intake.Background Iodine deficiency disorder (IDD) is continued to be a major public health problem in Ethiopia. The problem is worse but the data is scarce in some pocket areas of the country. This study was aimed to assess the magnitude of IDD and associated factors in southwest Ethiopia by using different biochemical and clinical indicators. Methods Both community and school based cross- sectional study was conducted on school age children (6-12 years) from March 1 to 24, 2017. https://www.selleckchem.com/products/etomoxir-na-salt.html Simple random and systematic sampling techniques were applied to select districts and eligible children respectively. Household data was collected from children's primary care takers by using structured questionnaire. A trained surgeon examined all children (n = 652) for goiter. Urine sample was collected from 20% of children (n = 130). Results A total of 652 school children were participated in the study. Total goiter rate and median urinary iodine concentration (UIC) was 54.8% and 96.12 μg/l respectively. In multivariable logistic regression analyses student's age was significantly (P less then 0 05) associated with both goiter and median UIC. However; sex of students and family income were significantly (P less then 0.001) associated with goiter and cassava consumption was significantly (P less then 0.001) associated with UIC. Conclusion As indicated by the median UIC, there was mild iodine deficiency in this study community. However; chronic iodine deficiency was still a severe public health problem (high goiter prevalence). In addition, there was low concentration of iodine in the salt and increased cassava cultivation and consumption indicating the potential risk in the area. Therefore, it is necessary to intensify IDD elimination activities along with teaching communities on techniques of cassava processing for household consumption. Trial registration PACTR201809544276357. Retrospectively registered on 14, Sept 2018.This study qualitatively explores differences in psychological contract (PC) content between Belgian and Chinese employees, while attempting to understand these differences from the perspective of cultural values. We build on theory concerning horizontal and vertical individualism/collectivism to interpret differences in PC content. 21 Chinese and 20 Belgian employees were interviewed, with results indicating that Belgian interviewees' PCs tend to be balanced with an emphasis on egalitarian interpersonal relationships, reflecting a horizontal collectivist culture. We propose that a "culture of compromise" forms a fitting description for Belgian interviewees' PCs. For Chinese interviewees, the PC was characterized by mixed contracts aligning with the ideology of 'Utilitarianistic Guanxi', which forms a Chinese philosophy that combines the pursuit of profit with objective goods, reflecting a culture of vertical collectivism.Purpose of program This paper will provide guidance on how to best manage patients with end-stage kidney disease who will be or are being treated with home dialysis during the COVID-19 pandemic. Sources of information Program-specific documents, pre-existing, and related to COVID-19; documents from national and international kidney agencies; national and international webinars, including webinars that we hosted for input and feedback; with additional information from formal and informal review of published academic literature. Methods Members of the Canadian Society of Nephrology (CSN) Board of Directors solicited a team of clinicians and administrators with expertise in home dialysis. Specific COVID-19-related themes in home dialysis were determined by the Canadian senior renal leaders community of practice, a group compromising medical and administrative leaders of provincial and health authority renal programs. We then developed consensus-based recommendations virtually by the CSN work-group with input from ethicists with nephrology training.